By: Jenna Rehnstrom
jrehnstrom@kcautv.com
An important deadline is looming in the future of the affordable care act, or what some call "Obamacare." The law calls for the creation of health insurance exchanges. Those are either state–run or federal–run markets where households and small businesses can shop for private coverage.
States originally had until Friday to declare if they want to have a state–run program. But on Thursday, Secretary of Health and Human Services Kathleen Sibelius extended the deadline to December 14th.
South Dakota has already decided to go with the federal run option. Nebraska Governor Dave Heineman announced Thursday that state's decision to do the same. saying the state–run exchange would be just too expensive for Nebraska taxpayers.
In a statement, he said, "As Governor, my focus is on implementing the federal health care law in the most efficient and cost effective manner for Nebraskans and their families."
Iowa has yet to decide and says they need more information from the government.
Tim Albrecht from Governor Branstad's office had this to say: "It is loathsome for the federal government to force a heavy–handed, arbitrary deadline to states without answering the fundamental questions on how we proceed with implementation. It would be irresponsible for the state of Iowa to move forward with an exchange without having the answers we need from the federal government."
So what's next? Over the next year, these exchanges will be set up in some fashion and people will be required to buy insurance. At a time when our local hospitals are seeing the number of uninsured patients skyrocket, some are anxiously awaiting the result that more coverage could bring.
The uncertainty for America's changing healthcare system may have gotten a bit more clear. The outcome of the presidential election all but solidifies the Affordable Care Act – in particular, the insurance mandate that goes into affect in 2014.
Politics aside, though, Mercy Medical Center's Jim Wharton says this could be a game–changer for hospitals trying to care for the growing number of uninsured patients.
"The hospitals are left holding huge charges that they're never going to be reimbursed [for] or collected on. You can't do that forever, at some point in time you reach a critical mass where you can no longer sustain that type of operation," Wharton said.
Nine percent of patients at Mercy Medical Center are uninsured. At St. Luke's, a similar situation, with more people needing care they can't pay for. But President and CEO Peter Thoreen says getting people insured, alone, is not enough.
"We have to do both – we have to get people insurance coverage, which is positive in our opinion, but we have to do a better job of lowering overall costs, how we all utilize healthcare and the outcomes that we get," Thoreen commented.
There's another important decision that's in the hands of the states. The Medicaid expansion intended to cover an additional 17 million Americans is now optional. And both hospitals are keeping a close eye on what could happen.
"We would encourage the state to take a hard look at that – all three states [that we serve] – and say how can we do that and still make each state feel like we can afford this and it makes sense," said Thoreen.
"From the hospital perspective, we hope that the governor and the legislature decides not to opt out, because it's still going to leave a lot of Iowans without insurance," commented Wharton.
The bottom line is: those people will still get the same care they always have at Mercy and St. Luke's. But, as we see these changes come into play, everyone will feel the affects of what will could become a vastly different way we look at healthcare.
Regarding the Medicaid expansion, if states decide to sign up, the federal government will cover 100% of the extra cost for three years.
